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Andy Stergachis, PhD; Kirkwood K. Shy, MD, MPH; Louis C. Grothaus, MS; Edward H. Wagner, MD, MPH; Julia A. Hecht, PhD, MPH; Garnet Anderson, PhD; Esther H. Normand, RRA; Janet Raboud, MS

JAMA. 1990;264(22):2893-2898.

Abstract
To assess the effect of tubal sterilization on the risk of hysterectomy, we studied 7414 women aged 20 to 49 years who had had a tubal sterilization at a health maintenance organization between January 1, 1968, and December 31,1983. Compared with a population-based cohort of nonsterilized women, women sterilized while 20 to 29 years old were 3.4 times more likely to have had a subsequent hysterectomy (95% confidence interval, 2.4 to 4.7). Adjustment for the effects of potential confounders with a subset of 276 women did not appreciably alter this association. For multivariate comparisons with 5323 wives of vasectomized men, there was no significant elevation in the risk of hysterectomy following sterilization among women sterilized while 20 to 29 years old. Tubal sterilization was not associated with hysterectomy for married women who underwent tubal sterilization at age 30 or older. These results do not support a biological basis for the relationship between tubal sterilization and hysterectomy.

(JAMA. 1990;264:2893-2898)

Author Affiliations
From the Center for Health Studies, Group Health Cooperative of Puget Sound (Drs Stergachis, Wagner, and Hecht, Mr Grothaus, and Ms Normand), and the Departments of Obstetrics and Gynecology (Dr Shy) and Biostatistics (Dr Anderson and Ms Raboud), University of Washington, Seattle.; Dr Stergachis is now with the Departments of Pharmacy and Epidemiology, University of Washington, Seattle. Ms Raboud is now with the University of Toronto (Ontario). Dr Anderson is now with the Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle.

Footnotes
Reprint requests to Program in Pharmacoepidemiology and Drug Policy, School of Pharmacy, SC-69, University of Washington, Seattle, WA 98195 (Dr Stergachis).

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